Mccarty, Tina Marie
Mccarty, Tina Marie is an individual health care provider with primary practice located at 1202 Moore Lake Dr E , Fridley MN 55432-5170. She recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Optometrist. Eye and Vision Services Providers / Corneal and Contact Management is her primary health care specialty. Mccarty, Tina Marie can be contacted via phone (763) 574-0075.Contact Information
Primary practice address
1202 Moore Lake Dr E
Fridley MN 55432-5170
Phone: (763) 574-0075
Fax: (763) 574-0594
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | 2837 | Minnesota |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2837 | Minnesota |
Profile Details
| NPI number | 1720046170 |
|---|---|
| LBN Legal business name | Mccarty, Tina Marie |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 3rd, 2006 |
| Last updated | Feb 19th, 2010 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1720046170 | NPPES |
| Minnesota | Other | P00348012 | RAILROAD MEDICARE |
| Minnesota | MEDICAID | 293648800 | RAILROAD MEDICARE |
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